Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands.
Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands.
Air Med J. 2024 Jul-Aug;43(4):308-312. doi: 10.1016/j.amj.2024.01.010. Epub 2024 Feb 22.
Intoxicated patients are often encountered by emergency medical services (eg, in cases of recreational drug use, accidental ingestion, or inhalation of toxic substances or [attempted] suicide). Earlier research showed that a physician-staffed helicopter emergency medical service (P-HEMS) is regularly dispatched for intoxicated patients. However, it is still unclear if there is added value of P-HEMS compared with standard care provided by an ambulance crew. The aim of this study was to analyze the contribution of additional expertise and equipment that P-HEMS brings to the prehospital scene.
In this retrospective study, we searched the database of the helicopter emergency medical service Lifeliner 1 serving the northwestern quadrant of the Netherlands for cases that involved intoxications from January 2013 to July 2020. Patients were included in this study if the primary reason for P-HEMS dispatch was intoxication. The types of intoxication were categorized as (illicit/recreational) drug related, suicide attempt, or accidental. The agents were categorized as stimulants, depressants, hallucinogenic, cannabinoids, and other substances such as bleach or insulin. Patient characteristics, vital signs, and the therapeutic interventions performed were recorded for analysis.
In our study period, P-HEMS was dispatched 23,878 times. Of these dispatches, a total of 259 cases were included for further analysis. The majority of patients were male (64.5%). Sixty-six patients (25.5%) had an intoxication of depressant agents alone, whereas 60 patients (23.2%) had an intoxication with a combination of agents. With 159 (61.4%) patients, the majority of cases involved recreational drug intoxications. Unintentional intoxications were treated in 27 (10.4%) patients, whereas 73 (28.2%) cases involved suicide attempts. In 159 patients (61.4%), prehospital endotracheal intubation was required; the vast majority was performed by the helicopter emergency medical service physician. Specific antidotes were administered in 56 (21.6%) of the cases.
In this study, we found that P-HEMS crews might complement usual prehospital care by ambulance crews for patients with severe intoxications by bringing advanced skills (eg, airway management and specific antidotes) to the scene.
急救医疗服务（例如，在娱乐性药物使用、意外摄入、或吸入有毒物质或[试图]自杀的情况下）经常会遇到醉酒患者。早期研究表明，配备医生的直升机紧急医疗服务（P-HEMS）经常被派往醉酒患者。然而，目前尚不清楚与救护车机组人员提供的标准护理相比，P-HEMS 是否具有附加价值。本研究旨在分析 P-HEMS 为现场带来的额外专业知识和设备的贡献。
在这项回顾性研究中，我们搜索了荷兰西北部 Lifeliner 1 直升机紧急医疗服务数据库，寻找从 2013 年 1 月至 2020 年 7 月期间因醉酒而被派遣的案例。如果 P-HEMS 派遣的主要原因是醉酒，则将患者纳入本研究。将中毒类型归类为（非法/娱乐性）药物相关、自杀企图或意外。将药剂归类为兴奋剂、镇静剂、致幻剂、大麻素和其他物质，如漂白剂或胰岛素。记录患者特征、生命体征和进行的治疗干预措施以供分析。
在我们的研究期间，共派遣了 23878 次 P-HEMS。在这些派遣中，共有 259 例被纳入进一步分析。大多数患者为男性（64.5%）。66 名患者（25.5%）单独使用镇静剂药物中毒，而 60 名患者（23.2%）使用多种药物联合中毒。在 159 名患者（61.4%）中，大多数病例涉及娱乐性药物中毒。27 名患者（10.4%）为非故意中毒，73 名患者（28.2%）为自杀企图。在 159 名患者（61.4%）中，需要进行院前气管插管；绝大多数由直升机紧急医疗服务医师进行。在 56 例（21.6%）病例中给予了特定的解毒剂。
在这项研究中，我们发现 P-HEMS 机组人员可以通过将高级技能（例如气道管理和特定解毒剂）带到现场，为严重中毒的患者补充常规的院前护理。
